Correction to: Effect of JAK inhibitors on high- and low-density lipoprotein in patients with rheumatoid arthritis: a systematic review and network meta-analysis

Clinical Rheumatology -     

Impact of the COVID-19 pandemic on the hospital attendance of patients with primary cervical cancer in Heilongjiang,China

Information regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on cervical cancer in mainland China is lacking. We explored its impact on the hospital attendance of patients with primary cervical cancer. We included 1918 patients with primary cervical cancer who initially attended Harbin Medical University Cancer Hospital between January 23, 2019, and January 23, 2021. Attendance decreased by 31%, from 1135 in 2019 to 783 in 2020, mainly from January to June (𝜒² = 73.362, P < .001). The percentage of patients detected by screening decreased from 12.1% in January-June 2019 to 5.8% in January-June 2020 (𝜒² = 7.187, P = .007). Patients with stage I accounted for 28.4% in 2020 significantly lower than 36.6% in 2019 (𝜒² = 14.085, P < .001), and patients with stage III accounted for 27.1% in 2020 significantly higher than 20.5% in 2019 (𝜒² = 11.145, P < .001). Waiting time for treatment was extended from 8 days (median) in January-June and July-December 2019 to 16 days in January-June (𝜒² = 74.674, P < .001) and 12 days in July-December 2020 (𝜒² = 37.916, P < .001). Of the 179 patients who delayed treatment, 164 (91.6%) were for the reasons of the healthcare providers. Compared to 2019, the number of patients in Harbin or non-Harbin in Heilongjiang Province and outside the province decreased, and cross-regional medical treatment has been hindered. The COVID-19 pandemic has negatively impacted cervical cancer patient attendance at the initial phase. These results are solid evidence that a strategy and mechanism for the effective attendance of cervical cancer patients in response to public health emergencies is urgently needed.     

Diffusion-weighted magnetic resonance imaging in rat kidney using two-dimensional navigated,interleaved echo-planar imaging at 7.0 T

The purpose of this study was to investigate the feasibility of two-dimensional (2D) navigated, interleaved multishot echo-planar imaging (EPI) to enhance kidney diffusion-weighted imaging (DWI) in rats at 7.0 T. Fully sampled interleaved four-shot EPI with 2D navigators was tailored for kidney DWI (Sprague–Dawley rats, n = 7) on a 7.0-T small bore preclinical scanner. The image quality of four-shot EPI was compared with T₂-weighted rapid acquisition with relaxation enhancement (RARE) (reference) and single-shot EPI (ss-EPI) without and with parallel imaging (PI). The contrast-to-noise ratio (CNR) was examined to assess the image quality for the EPI approaches. The Dice similarity coefficient and the Hausdorff distance were used for evaluation of image distortion. Mean diffusivity (MD) and fractional anisotropy (FA) were calculated for renal cortex and medulla for all DWI approaches. The corticomedullary difference of MD and FA were assessed by Wilcoxon signed-rank test. Four-shot EPI showed the highest CNR among the three EPI variants and lowest geometric distortion versus T₂-weighted RARE (mean Dice: 0.77 for ss-EPI without PI, 0.88 for ss-EPI with twofold undersampling, and 0.92 for four-shot EPI). The FA map derived from four-shot EPI clearly identified a highly anisotropic region corresponding to the inner stripe of the outer medulla. Four-shot EPI successfully discerned differences in both MD and FA between renal cortex and medulla. In conclusion, 2D navigated, interleaved multishot EPI facilitates high-quality rat kidney DWI with clearly depicted intralayer and interlayer structure and substantially reduced image distortion. This approach enables the anatomic integrity of DWI-MRI in small rodents and has the potential to benefit the characterization of renal microstructure in preclinical studies.     

基于DEA方法的华法林抗凝分级管理模式的效率评价

目的:通过小范围的临床实践,使用数据包络分析(data envelopment analysis,DEA)方法对基于全程化抗栓药学服务模式的华法林抗凝管理工作效率进行评价。方法:选取2021年7-12月南京大学医学院附属鼓楼医院心胸外科瓣膜置换术后使用华法林抗凝的患者。将患者分为实验组和对照组,实验组由临床药师利用基于分级管理的全程化抗栓药学服务模式进行抗凝管理和药学监护,对照组由临床药师按照无差别监护模式进行抗凝管理和监护,记录2种模式下药师工作内容和工作成效,通过DEA方法分析比较2种抗凝管理模式的效率。结果:研究最终纳入服用华法林的患者233人(实验组116人,对照组117人),实验组的单位患者管理时间显著减少[(27.8±9.7)min vs.(34.8±11.4)min]。经模型计算后,实验组的总体效率值为1,说明其投入和产出最优,且效率高于对照组。结论:全程化抗栓药学服务模式下药师管理单位抗凝患者需要的时间更少,管理效率更高。